Basic Information
Provider Information
NPI: 1821488479
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEWART
FirstName: ASHLEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6330 QUADRANGLE DR STE 500
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275178281
CountryCode: US
TelephoneNumber: 9199325700
FaxNumber:  
Practice Location
Address1: 6330 QUADRANGLE DR STE 500
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275178281
CountryCode: US
TelephoneNumber: 9199325700
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/03/2015
LastUpdateDate: 11/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XP012153NCY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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